Splenic calcification following treatment of Hodgkin's disease

Abstract

Calcification within the spleen has many different manifestations and aetiologies. We report a single case of a patient with Stage IV Hodgkin disease who developed splenic calcification following chemotherapy. A search of the literature has failed to reveal a previous report of this phenomenon. A 43-year-old man presented with a 6-month history of increasing painless swelling in the left side of his neck. Latterly this had been accompanied by the development of further smaller cervical nodules. He was otherwise asymptomatic. On examination, mobile rubbery lymph nodes were confirmed in the left cervical and supra-clavicular regions, the largest being up to 1 cm in diameter. Smaller nodes were also found in the left axilla and both inguinal regions. One of the nodes in the left posterior cervical triangle was removed and histological examination revealed mixed cellularity Hodgkin disease. A plain radiograph of the chest demonstrated no abnormality and computed tomography (CT) of the thorax and abdomen was performed to delineate the extent of the disease. There was no evidence of mediastinal or other lymph node enlargement; the liver and spleen were normal in size and shape and contained no focal abnormality (Fig. 1). A bipedal lymphogram was performed which demonstrated an unusual and suspicious appearance in the proximal inguinal regions. Lymph node biopsy revealed no evidence of disease. The patient was therefore staged as IA mixed cellularity Hodgkin disease.